Evaluation methods. Competency domain. Teaching methods. Goals and Objectives Procedure Elective PC P SBP. Clinical encounters

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1 rocedure Elective lease note that the list of procedures is comprehensive. GOAL: Diagnostic Testing. Use and perform common diagnostic tests and imaging studies, and technical and therapeutic procedures appropriately in the outpatient, ED, inpatient, ICU and NICU settings. C SB rocedure Demonstrate understanding of common diagnostic tests and imaging studies, and technical and therapeutic procedures used in outpatient, ED, inpatient, ICU and NICU settings by being able to: Explain the indications for and limitations of the study. Understand the benefits and disadvantages of family presence during procedures. Discuss cost and utilization issues performance of this procedure) with the following Arterial puncture (*) Breast pump use Bladder catherization (*) Capillary blood collection Chest tube placement (**) Cerumen removal Foreign body removal: nose, ear, subcutaneous, vagina (**) Gynecoic examination: prepubertal and pubertal (*) Intravenous line placement (*) Intraosseous line placement (*) Liquid nitrogen for molluscum/warts Lumbar puncture (*) Medication delivery: inhaled (**), IM/SC, rectal, IV rocedural sedation (*) ain management (*) D placement ulmonary function tests Skin scraping Suctioning: nares, O, tracheostomy Umbilical artery and vein catheter placement (*) Venipuncture (*) Wood s lamp examination of skin

2 rocedure Elective lease note that the list of procedures is comprehensive. Cardiopulmonary resuscitation: o BLS (*) o NR (*) o ALS (*) Work towards developing skill with these Digital blocks Suprapubic tap Endotracheal intubation (*) Tracheostomy tube replacement Work towards understanding the following procedure and when to use it: Circumcision (**) Broncho-alveolar lavage/bronchoscopy Colonoscopy/sigmoidoscopy EGD Renal biopsy Liver biopsy Bone marrow aspiration/biopsy GOAL: Diagnostic and Screening rocedures (Ophthalmoy). erform diagnostic and screening procedures associated with pediatric ophthalmoy. C rocedure Vision screening (acuity and strabismus; color blindness) (**) Fluorescein dye test to detect corneal abrasion Conjunctival swab for bacteria and chlamydia Removal of simple corneal foreign body (**) Eye irrigation Lid eversion Contact lens removal

3 rocedure Elective lease note that the list of procedures is comprehensive. GOAL: Therapeutic rocedures (Orthopedics). Acquire recommended proficiencies in orthopedic therapeutic procedures C rocedure Immobilization techniques, reduction and splinting for common fractures and sprains (*) Arthrocentesis Reduction of nursemaid's elbow Cervical spine immobilization GOAL: Therapeutic and Technical rocedures (Surgery). Acquire recommended proficiency in the use and performance of common surgical procedures. C rocedure Incision and drainage of simple abscess, including paronychia (**) Gastric suction and lavage lacement of gastric tube (orogastric or nasogastric) Reduction of simple hernia Central line use and care Suture of simple lacerations (*) Needle thoracentesis (**) Simple wound care (*) Burn management of 1 st and 2 nd degree burns

4 rocedure Elective lease note that the list of procedures is comprehensive. Drainage of subungual hematoma Work towards understanding the following procedure and when to use it Gastrostomy tube replacement Suction rectal biopsy Goal: Diagnostic Studies, rocedures, and Laboratory Data. Use diagnostic studies such as laboratory, radioy, and procedures to assess patients and monitor treatment, understanding the potential invasiveness and cost of tests ordered. C C SB rocedure Defend choice of any invasive, painful, or expensive diagnostic test or procedure in terms of risks and benefits to patient. 1. Identify risks and benefits for common diagnostic studies and procedures. 2. Discuss general costs of diagnostic tests and procedures and consider cost when selecting these tests/procedures. Explain medical tests and procedures to patients and parents in terms they can understand, including indications, contraindications, potential complications, and results; provide information in a supportive manner that enables them to participate actively in care plans. Demonstrate the appropriate level of competence for diagnostic procedures and screening tests expected of general pediatricians. * = RRC training requirement, ** RRC exposure requirement

5 atient Care (C): Make informed diagnostic and therapeutic decisions based on patient information, current scientific evidence and clinical judgment, using clinical problem-solving skills, recognizing the limits of one's knowledge and expertise, gathering appropriate information and using colleagues and consultants appropriately. rescribe and perform competently all medical procedures considered essential for the scope of general pediatric practice; be familiar with those procedures commonly used by subspecialists and other professionals who care for children. Counsel patients and families in a supportive manner so they can understand their illness or injury and its treatment, share in decision-making, make informed consent and participate actively in the care plan. rovide effective preventive health care and anticipatory guidance to patients and families. Communication (C): Communicate effectively in a developmentally appropriate manner with patients and families to create and sustain a therapeutic relationship across the broad range of socioeconomic and cultural backgrounds. Maintain comprehensive, timely and legible medical records. rofessionalism (): Consistently use compassion and empathy in one's role as a physician. Systems-based practice (SB): ractice cost-effective health care and resource allocation that does not compromise quality of care. Explanation for level of understanding and skill for procedures Work towards understanding the following procedure and when to use it or Level 1, Cognition: Resident is not required to master performance of this procedure, but should understand how it works and when to use it. (These are generally not performed by the pediatrician in practice, but may be commonly ordered from subspecialists.) procedure or Level 2, Fixation: Resident is developing skill with this procedure, but is still practicing it and becoming familiar with its complexities. (ediatricians use it occasionally in practice, and residents may perform it sometime during training.) performance of this procedure) or Level 3, Autonomy: Resident should master the performance of this procedure. (ediatricians use it regularly in practice.)

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